title: The efficacy of several neuromuscular monitoring modes at the P6 acupuncture point in preventing postoperative nausea and vomiting.
abstract: BACKGROUND
  In this study, we tested the efficacy of several neuromuscular monitoring modes at the P6 acupuncture point for preventing postoperative nausea and vomiting (PONV).
  
  
  METHODS
  In this prospective, double-blind, randomized, placebo-controlled trial, 264 women undergoing laparoscopic hysterectomy were evaluated for PONV. Neuromuscular blockade was monitored by acceleromyography with 1-Hz single twitch (ST) over the ulnar nerve (n = 54, control), and ST (n = 52), train-of-four (n = 53), double-burst stimulation (n = 53), or tetanus (n = 52) over the median nerve stimulating at the P6 acupuncture point.
  
  
  RESULTS
  The incidence of PONV (P = 0.022), the number of requests for patient-controlled analgesia (P = 0.009), and total patient-controlled analgesia volume (P = 0.042) 6 hours after tetanic stimulation were significantly reduced in the treatment group compared with the control group. Overall, patients in the tetanus group were more satisfied with the management of PONV compared with patients in the control group.
  
  
  CONCLUSIONS
  Tetanic stimulation applied to the P6 acupuncture point can reduce PONV after laparoscopic hysterectomy compared with ST stimulation of the ulnar nerve, resulting in a greater degree of patient satisfaction. None of the stimulations, ST, train-of-four, or double-burst, applied to the P6 acupuncture point significantly affected PONV.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Kwandong University, Goyang Si, Gyeonggi-Do, Korea.
authors.forename: Yong H
authors.initials: YH
authors.lastname: Kim
authors.forename: Kyo S
authors.initials: KS
authors.lastname: Kim
authors.forename: Hee J
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jae C
authors.initials: JC
authors.lastname: Shim
authors.forename: Sung W
authors.initials: SW
authors.lastname: Yoon
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation; D007702:Kinetocardiography / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D019148:Neuromuscular Blockade / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D020250:Postoperative Nausea and Vomiting / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome